Results in Wales are far from disastrous for Labour - but things still look bleak

Unlike in England, Wales saw full elections for all of its local authorities yesterday. After the shock of last week’s poll suggesting that Labour might lose their first general election in Wales since 1918, what message emerges from the local elections about the prospects for June 8th?

Five years ago, Welsh Labour did very well in the Welsh local elections, increasing the number of council seats they held by around 70%; by the end of that night they had substantially more councillor in Wales than did the Conservatives, Plaid Cymru and the Liberal Democrats put together. With Labour now polling around twenty points lower in Wales than they were in 2012, it was inevitable that they would lose ground. The big questions were how much ground and to whom? Would Labour now be in the nightmare position that the Conservatives were in the 1990s – when they were so unpopular that many voters would turn to pretty much whichever party locally was in a position to unseat them? Or would we find that Labour was better able to fight off some challengers than others?

As is per usual with local elections, there has been plenty of patchiness in the results: parties losing in some places and gaining in others. But beneath this noise, and although we await some final councils to declare, the broad signal from these elections is clear. Labour did lose ground, but it did not have the dreadful night that many in the party had feared.

The party entered the night with nearly 600 council seats and majority control of nearly half the councils in Wales. They will likely end up with their number of councillors reduced by over 100, and the number of councils under Labour control almost halved. But the election was very far from a total disaster. Labour actually gained a little ground in Flintshire and Swansea and showed impressive resilience to hold onto majority control of both Cardff and Newport.

In other places, notably Blaenau Gwent, Merthyr and Wrexham, Welsh Labour performed much less well. But even here there was a silver lining for the party, with the general election in mind. Labour’s big losses in these councils were not against the other main parties who they will be fighting in the general election, but against independent candidates.

The Welsh Conservatives made some gains, but more patchily than in much of England. They will be encouraged by the ground they have made in Bridgend, for example – a key winnable seat for them in the general election. But overall these local elections suggest that while the people of Wales may be more inclined to support the Conservatives in the context of a general election, they have certainly not yet fallen in love with the Tories.

Still, even the limited progress made by the Wesh Conservatives looks better than the performance of Labour’s other opponents. Plaid Cymru have made only a small number of net gains. While they should narrowly retain their position as the second party of local government in Wales, they must surely be disappointed: with Labour on the defensive they really should be doing better than this. Plaid need to ask themselves some hard questions about why independent candidates were so much better equipped to defeat Labour than they were.

Yet even the performance of Plaid looks good in comparison to that of the Liberal Democrats. It is difficult to over-state how dreadfully the Welsh Lib-Dems did in the equivalent local elections five years ago. So it is also hard to credit that, far from making significant progress with their much heralded ‘fightback’, the Lib-Dems are actually on course to make a net loss of seats in Wales this year. About the best things we can say about the Loberal Democrats is that at least they did better than UKIP. The Kippers were irrelevant to the Welsh local elections five years ago, and they remained so in 2017. The brief flowering of Welsh UKIP between 2014-16 already appears to be fading rapidly.

The most recent Welsh opinion poll had Labour two points ahead in voting intentions for the council elections – but ten points behind for the general election. These local elections have been far from disastrous for Welsh Labour. Nonetheless, they hardly point to anything other than a difficult general election for the party in its strongest historical bastion.

David had taken the same tablets for years. Why the sudden side effects?

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did.